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Change 1
As published
21-I:30-b Restrictions on Self-Insured Plans.
The following restrictions apply to self-insured group health plans administered under this subdivision:
I. To the extent that the state assumes the risk with respect to the medical and surgical benefits provided under RSA 21-I:30, the state shall maintain a reserve at least equal to the sum of:
(a) Three percent of estimated annual claims and administrative costs of the health plan; and
(b) The amount determined annually by a qualified actuary to be necessary to fund the unpaid portion of ultimate expected losses, including incurred but not reported claims, and related expenses incurred in the provision of benefits for eligible participants, less any credit, as determined by a qualified actuary, for excess or stop-loss insurance. The reserve amount shall be maintained in the fund established under RSA 21-I:30-c. If the state self-insures for more than one employee group plan, a reserve meeting the requirements of this paragraph must be maintained for each plan.
II. The state may purchase excess or stop-loss insurance for any plan, with attachment levels and limits as recommended by a qualified actuary.
III. For the purposes of this section, "qualified actuary" shall mean an actuary who is a member of the American Academy of Actuaries qualified as to health reserving methodologies.
IV. The total amount required to be maintained in reserve pursuant to this section may be met within a reasonable period of time after the establishment of a reserve fund under RSA 21-I:30-c. The commissioner of administrative services shall ensure that during the time the state is working toward meeting the required reserves the state is able to pay the risk assumed in administering a self-insured group health plan.
Source. 2001, 251:3. 2003, 319:169. 2005, 177:62. 2009, 144:66, eff. July 1, 2009. 2015, 276:164, eff. July 1, 2015.
Your change, as a redline
21-I:30-b Restrictions on Self-Insured Plans.
The following restrictions apply to self-insured group health plans administered under this subdivision:
I. To the extent that the state assumes the risk with respect to the medical and surgical benefits provided under RSA 21-I:30, the state shall maintain a reserve at least equal to the sum of:
(a) Three percent of estimated annual claims and administrative costs of the health plan; and
(b) The amount determined annually by a qualified actuary to be necessary to fund the unpaid portion of ultimate expected losses, including incurred but not reported claims, and related expenses incurred in the provision of benefits for eligible participants, less any credit, as determined by a qualified actuary, for excess or stop-loss insurance. The reserve amount shall be maintained in the fund established under RSA 21-I:30-c. If the state self-insures for more than one employee group plan, a reserve meeting the requirements of this paragraph must be maintained for each plan.
II. The state may purchase excess or stop-loss insurance for any plan, with attachment levels and limits as recommended by a qualified actuary.
III. For the purposes of this section, "qualified actuary" shall mean an actuary who is a member of the American Academy of Actuaries qualified as to health reserving methodologies.
IV. The total amount required to be maintained in reserve pursuant to this section may be met within a reasonable period of time after the establishment of a reserve fund under RSA 21-I:30-c. The commissioner of administrative services shall ensure that during the time the state is working toward meeting the required reserves the state is able to pay the risk assumed in administering a self-insured group health plan.
Source. 2001, 251:3. 2003, 319:169. 2005, 177:62. 2009, 144:66, eff. July 1, 2009. 2015, 276:164, eff. July 1, 2015.
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